Loss of appetite in amyotrophic lateral sclerosis is associated with weight loss and decreased calorie consumption independent of dysphagia

Abstract

Background: In the current study, we aimed to determine normative values for muscle thickness and fasciculation prevalence in healthy subjects.Methods: We performed a prospective study from October to December 2018 in 65 healthy subjects. All subjects underwent quantitative sonographic evaluation of muscle thickness and fasciculation prevalence in the following 8 muscles: Biceps brachii, abductor pollicis brevis, first dorsal interosseous, abductor digiti minimi, quadriceps, tibialis anterior, extensor digitorum brevis, and abductor hallucis brevis.Results: Subject ages ranged from 21 to 82 years, with 63% women. Normative values for muscle thickness were determined using the fifth percentile. Multivariate regression analysis showed that sex, age, body mass index, and hand dominance affected muscle thickness. Fasciculations were observed frequently only in distal muscles.Conclusions: Normal values for muscle thickness were determined, and may enhance neuromuscular ultrasound sensitivity and serve as a basis for future studies. Larger series are needed to confirm these values.fasciculations, muscle thickness, muscle ultrasound, neuromuscular disorders, neuromuscular ultrasound, normative values

CNS glucose metabolism in Amyotrophic Lateral Sclerosis: a therapeutic target?

“…Although various studies have suggested that hypermetabolism could lead to loss of body weight in patients with ALS, a recent study by Steyn et al [62] reported no significant differences in body weight between hypermetabolic and normometabolic ALS patients, suggesting that other mechanisms such as loss of appetite and malnutrition may contribute to body weight loss. Indeed, loss of appetite has been shown in a subset of patients with ALS, which contributes to reduced food intake [63][64][65]. This is in agreement with studies that show malnutrition in patients with ALS.…”

Blood biomarkers and prognosis of amyotrophic lateral sclerosis

“…However, a declining pattern of haemoglobin after diagnosis was associated with a higher mortality, although the association was borderline significant. This finding lends further support to the important role of nutritional status in the survival of ALS patients, which is multifactorial and influenced by metabolism [16], energy intake, ease of breath, and appetite [17][18][19].…”

Altered skeletal muscle glucose-fatty acid flux in amyotrophic lateral sclerosis

“…However, given that hypermetabolism has not been shown to be associated with weight loss in human ALS ( Steyn et al , 2018a ), these divergent observations between ALS mice and patients suggest that multiple factors are likely to contribute to weight loss in patients with ALS. These include reduced capacity to meet energy requirements ( Ngo et al , 2017 ) [including loss of appetite resulting in loss of fat mass ( Ngo et al , 2019 ; Mezoian et al , 2020 )], as well as neurogenic wasting ( Al-Sarraj et al , 2014 ).…”